Management of Varicose Veins and Venous Insufficiency

Hamdan, Allen D.

doi:10.1001/jama.2012.111352

Cited by 116 publications

(93 citation statements)

References 90 publications

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“…Furthermore, varicose veins are demonstrated to be autosomal-dominant with incomplete penetrance. Offspring have a 90% chance of developing varicose veins if their parents have them (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

IQGAP1 modulates the proliferation and migration of vascular smooth muscle cells in response to estrogen

Huang

Jin

Zhou

et al. 2015

International Journal of Molecular Medicine

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Abstract. Vascular smooth muscle cell (VSMC) proliferation and migration has been proven to be a critical event in the development of varicosity. Variations in estrogen levels, a pathological event related to age and pregnancy, play a role in the pathogenesis of varicosity. Previous studies have reported a different response of VSMCs following estrogen stimulation. However, the exact mechanisms involved have not yet been elucidated. In the present study, we examined the responses of lesion and normal VSMCs treated with 10 -8 M 17β-estradiol (E 2 ) for 24 h. A differential effect of exposure to E 2 was observed in these cells. IQ-domain GTPase-activating protein 1 (IQGAP1), a scaffold protein, was overexpressed in the lesion VSMCs and was shown to modulate VSMC proliferation and migration in response to E 2 . Furthermore, the increased expression of IQGAP1 was found to be intimately associated with a high activity of estrogen receptor α (ERα), which has been implicated in the regulation of VSMC physiological function. Additionally, we found that two critical kinases, Akt and extracellular signal-regulated kinase (ERK), mediated the activation of ERα and VSMC proliferation. According to our results, we thus concluded that high levels of IQGAP1 in VSMCs regulate the physiological reaction of the cells in response to estrogen exposure, and that kinases are involved in the process by mediating ERα activation. In view of the essential role of IQGAP1 in the physiological function of VSMCs, targeting this molecule may prove to be a promising strategy for the treatment of varicosity.

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Section: Introductionmentioning

confidence: 99%

IQGAP1 modulates the proliferation and migration of vascular smooth muscle cells in response to estrogen

Huang

Jin

Zhou

et al. 2015

International Journal of Molecular Medicine

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“…Prevalence was higher in developed countries [10]. According to a western study, approximately 23 % of US adults had varicose veins, a disease being commoner in women and older adults (40-80 years) [11]. However, in the latest Edinburgh Vein Study (2014), there was no age or sex difference when a large population size was followed up for 13 years for the incidence of venous reflux [12].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Outcome of Duplex Ultrasound-Guided, Catheter-Directed Foam Sclerotherapy and Radio-frequency Ablation in the Management of Great Saphenous Varicose Veins

et al. 2016

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Chronic venous insufficiency of lower limbs is a common problem in adults. We compared the two modalities, namely duplex ultrasound-guided, catheter-directed foam sclerotherapy (UGFS) and radio-frequency ablation (RFA), in the management of great saphenous varicose veins using clinical assessment (Venous Clinical Severity Score, Venous Disability Score) and duplex imaging. Patients presenting with great saphenous vein (GSV) varicosity due to incompetent saphenofemoral junction (SFJ) were selected and randomly assigned in each arm, i.e., duplex UGFS group and RFA group. Patients were assessed on days 7, 30, and 90 both clinically and sonologically. Clinical assessment was based on the Venous Clinical Severity Score (VCSS) and Venous Disability Score (VDS). Obliteration of the treated GSV segment was noted in all the limbs of the RFA group (31/31) on duplex sonography on days 7, 30, and 90, while in the UGFS group, out of 30 limbs, obliteration was successful in 28 (28/ 30) and 2 had treatment failure. However, outcome of both the groups were statistically comparable (P value > 0.05). After the procedure, improvement in the VCSS was noted in both the study arms in every follow-up and both the modalities were found to be equally effective. Improvement in the Venous Disability Score was there on every follow-up, but maximum improvement was seen on the second visit, i.e., post-treatment day 30. Improvement was statistically significant and equal in both arms after the initial 1 week. Foam sclerotherapy, especially catheter-directed, is as effective as radio-frequency ablation in achieving anatomical obliteration and yielding relief in clinical signs and symptoms in patients with GSV varicosity with SFJ incompetence.

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“…Approximately 23% of US adults have varicose veins. 1 If spider telangiectasias and reticular veins are also considered, the prevalence increases to 80% of men and 85% of women. 2 Generally more common in women and older adults, varicose veins affect 22 million women and 11 million men between the ages of 40 to 80 years.…”

Section: Overviewmentioning

confidence: 99%

“…2 Generally more common in women and older adults, varicose veins affect 22 million women and 11 million men between the ages of 40 to 80 years. 1 Of these, 2 million men and women will develop symptoms and signs of chronic venous insufficiency, including venous ulceration.…”

Section: Overviewmentioning

confidence: 99%

“…Surgical stripping is associated with varicose vein recurrence in up to 50% of patients by 5 years, most often as a result of incomplete phlebectomy, persistent venous reflux, or neovascularization. 1 Complications of surgical stripping include extensive Endovenous therapy with either radiofrequency or laser ablation relies on thermal injury to cause thrombotic and fibrotic closure of the saphenous veins in patients with documented superficial venous reflux. local tumescent anesthesia is required for patient comfort, to separate the vein from the skin surface, and to protect surrounding tissue from heat injury.…”

Section: Therapies For Varicose Veinsmentioning

confidence: 99%

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